Primary radiation therapy for T1 glottic cancer. Factors influencing local control.

One hundred and seventy-four patients with early glottic cancer received radiation therapy on the kV250 and cobalt 60 machines. Crude survival rates at 5, 10 and 15 years were 83%, 73% and 60%, respectively. Salvage surgery for locoregional recurrences was successful in 85% of the patients. A significantly higher failure rate was noted in patients with a pre-existing chronic laryngitis, with lesions confined to the left vocal cord and in those treated with KV250 irradiation. The rate of second primaries in this case material was 11%, 70% of which were noted in the respiratory tract. Megavoltage radiotherapy offers excellent chances for cure in T1 laryngeal carcinoma with preservation of good voice in most patients. Patients with chronic laryngitis carry a high risk of local recurrence and therefore should be considered for primary conservation surgery.